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Ciccarone Articles

Ciccarone Center Research


Cholesterol / Lipids / Statins

Landmark Articles

Effect of equivalent on-treatment apolipoprotein levels on outcomes (from the AIM-HIGH and HPS2-THRIVE).
By: Al-Hijji M, Martin SS, Joshi PH, Jones SR.

This viewpoint study seeks to explore the recent failures of the niacin trials through apolipoprotein lens.

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Friedewald estimated versus directly measured low-density lipoprotein cholesterol and treatment implications.
By: Martin SS, Blaha MJ, Elshazly MB, Brinton EA, Toth PP, McEvoy JW, Joshi PH, Kulkarni KR, Mize PD, Kwiterovich PO, Defilippis AP, Blumenthal RS, Jones SR.
This study discovered that, compared with direct measurement, the Friedewald equation tends to underestimate low-density lipoprotein cholesterol (LDL-C) and, therefore, warrants additional evaluation in high-risk patients. Achieving non-high-density lipoprotein cholesterol (HDL-C) targets are important to reach in the secondary prevention setting.
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Non-HDL cholesterol, guideline targets, and population percentiles for secondary prevention in a clinical sample of 1.3 million adults: the very large database of lipids (VLDL-2 Study).
By: Elshazly MB, Martin SS, Blaha MJ, Joshi PH, Toth PP, McEvoy JW, Al-Hijji MA, Kulkarni KR, Kwiterovich PO, Blumenthal RS, Jones SR.
There is significant patient-level discordance between non-HDL-C and LDL-C percentiles at lower values of LDL-C and higher triglycerides. Current non-HDL-C cut-points for high-risk patients should be lowered to match percentiles of LDL-C cut-points. Relatively small absolute reductions in non-HDL-C cut-points result in substantial reclassification of patients to higher treatment categories with potential implications for risk assessment and treatment.
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The role of statins in diabetes mellitus.
By: Subedi BH, Tota-Maharaj R, Silverman MG, Minder CM, Martin SS, Ashen MD, Blumenthal RS, Blaha MJ.

Diabetes is considered a risk equivalent for coronary heart disease (CHD). The use of statins for primary and secondary prevention in patients with diabetes is well established and supported by robust data from randomized, controlled trials and national guidelines. The American Diabetes Association recommends that individuals with diabetes and a history of cardiovascular disease (CVD), as well as those > 40 years of age without CVD but with CVD risk factors, should be treated with a statin regardless of their baseline LDL cholesterol concentration. This review explains the rationale behind considering diabetes a CHD risk equivalent and summarizes the data for statin use in adults with diabetes without (primary prevention) and with (secondary prevention) established CVD. Although individuals with diabetes are at an increased risk for CVD and benefit from statin therapy, the risk of CVD in people with diabetes is heterogeneous. It therefore may be reasonable to match the intensity of statin therapy with patients' baseline CVD risk.

Obesity, adiposity, and dyslipidemia: A consensus statement from the National Lipid Association.
By: Bays HE, Toth PP, Kris-Etherton PM, Abate N, Aronne LJ, Brown WV, Gonzalez-Campoy JM, Jones SR, Kumar R, La Forge R, Samuel VT.
The goal of this statement is to better define the effect of adiposity on lipoproteins, how the pathos of excessive body fat (adiposopathy) contributes to dyslipidemia, and how therapies such as appropriate nutrition, increased physical activity, weight-management drugs, and bariatric surgery might be expected to impact dyslipidemia.
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Discordance: Can we capitalize on it to better personalize atherosclerosis treatment?
By: Nasir K, Martin SS, Virani S.
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Disorders of lipid metabolism.
By: Martin SS, Blumenthal RS.
This chapter examines the evidence base for selective use of lipid-lowering agents in adults over the age of 65.
Which serum cholesterol markers should I use to lower my patient’s cardiovascular risk?
By: Makadia S, Harrington C, Blumenthal RS.
We reviewed the strengths and limitations of LDL-C, non-HDL-C, apolipoprotein B, and advanced lipoprotein testing in cardiovascular risk prediction.
Nonfasting lipids: there is the population and then there is the patient.
By: Martin SS, Blaha MJ, Jones SR.

This article reviews the rationale for the measurements of lipids in the nonfasting state.

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The association of elective hormone therapy with changes in lipids among glucose intolerant postmenopausal women in the diabetes prevention program.
By: Golden SH, Kim C, Barrett-Connor E, Nan B, Kong S, Goldberg R; the Diabetes Prevention Program Research Group.

It is unclear how lipids change in response to lifestyle modification or metformin among postmenopausal glucose intolerant women using and not using hormone therapy (HT). We examined the one-year changes in lipids among postmenopausal, prediabetic women in the Diabetes Prevention Program (DPP), and whether changes were mediated by sex hormones. The beneficial effects of ILS and metformin on lowering LDL-C and raising HDL-C differ depending upon concurrent HT use.

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